 Hello everyone. I am Dr. Saptarshi Sena, 3rd year junior resident, Topiwala National Medical College and BYL Nair, Charitable Hospital Mumbai, affiliated to Maharashtra University of Health Sciences. My paper is on the role of ultrasonography in detecting posterior ankle pain pathologies. The aim of the study is to identify the role of ultrasonography in detecting the various causes of posterior ankle pain. Complex anatomy of the foot necessitates compartmentalized evaluation of foot. Posterior ankle region comprises soft tissue structures behind tibial taller joint and calcaneus with achilles tendon being the central axis. Imaging helps in visualization of deeper non palpable structures. Ultrasonography is a rapid dynamic and cost effective tool for tendon pathologies and joint effusion. Study design, cross sectional, study duration 3 months, place of study radiology department of BYL Nair Hospital, sample size 30, methodology. Ultrasonography was performed on patients with age ranging from 18 to 60 years on Samsung RS-80A machine using linear array transducer 3 to 16 megahertz. Exclusion criteria, history of recent ankle surgery or fracture, PRP injection in past six months. Scanning position prone with feet hanging freely from the age of examination bed. Results. The study consists of 30 patients age ranging from 18 to 60 years presenting with posterior ankle pain. Out of 30 cases included in our study, 27 that is 90 percent showed a detectable pathological cause of pain while 3 that is 10 percent did not reveal any obvious abnormality. Pathologies detected were achilles tendinosis that is the commonest 41 percent, achilles tendon tear, achilles paratinalitis, achilles xanthomas, retrocalcaneal bursitis, plantar neurofibromatosis, plantar fasciitis and plantar fibromatosis. Ultrasonography was successful in detecting the pathology in 90 percent of the cases as shown in the pie chart. Out of which 41 percent was achilles tendinosis the commonest. Posterior ankle pain is a result of wide spectrum of local and systemic conditions ranging from degenerative to inflammatory pathologies. Ultrasonography is an easily available and less time consuming modality. Stress and dynamic ultrasonography can help in diagnosing tendon tear easily. Easy comparability with the contralateral limb in case of diagnostic dilemma. Doppler examination plays pivotal role. Wide spectrum of pathologies were picked up on ultrasonography in posterior ankle pain with good diagnostic accuracy. Coming to the images as we can see in the various images showing calcific achilles enthisopathy. There is intra substance achilles calcifications noted as can be seen in the various images. The next pathology detected was achilles tendon tear. Here is a partial thickness achilles tendon tear as observed in the longitudinal and transverse sections. Here is a complete tear of the achilles tendon with waviness preserved on the proximal and distal fibres. Again a complete thickness tear of achilles tendon shown in the transverse section. Both image A and B show retrocalcaneal bursitis. Here is a case of a left planter neurofibromatosis along with the clinical image as given. Bilateral achilles tendons anthomas demonstrated over here in the images. Now coming to the pathologies of the planter fascia, posterior ankle examination is incomplete without the examination of the planter fascia as planter fascia pathologies can cause pain in posterior ankle region. Image A demonstrates a diffuse thickening of planter fascia which indicates planter fasciitis. Here is a focal thickening of planter fascia showing planter fibromatosis. Now role of color Doppler in ankle imaging. Highly raised vascularity of achilles paratinum demonstrated in image A suggestive of achilles paratinalitis. Hydrogenous ecotexture with loss of normal fibrillary pattern of achilles tendon demonstrated in image B with raised Doppler vascularity shows achilles tendinosis. Image C demonstrates retrocalcaneal bursitis where there is highly raised vascularity around the retrocalcaneal bursa with heterogeneous ecotexture of the bursa and focal defect in the calcaneus. Here are my references. Thank you.